CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $238
  • Cash Discount Price: $2,473
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Mercy Hospital Pittsburg, Inc is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,473. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$2,473

Average discount available for prompt cash payment at this facility.

Insurance Median
$238

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $2,473 (1014%)
Insurance Median: $238 (98%)
Cash: $2,473 (1014% of Medicare)
Ins. Median: $238 (98% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $110 - $235 45%
Humana $110 - $231 45%
Aetna $110 - $3,234 45%
Blue Cross Blue Shield $131 - $665 54%
UnitedHealthcare $206 - $2,565 85%
Medicare (plans) $231 - $240 95%
Tricare $231 95%
American Health Advantage Of Ks Mcr Contracted [320508] $231 95%
Kindful Hospice Contracted [320434] $231 95%
Dept Of Veteran Affairs Contracted [320106] $231 95%
Kindful Hospice [20434] $231 95%
Elara Caring Aspire Hospice [20433] $231 95%
Mercy Hospice Okc [20252] $231 95%
Pace Of The Ozarks Contracted [320518] $231 95%
Halo Hcr Inc Hospice Contracted [320432] $231 95%
Cross Timbers Hospice [20098] $231 95%
Halo Hcr Inc Hospice [20432] $231 95%
Ambetter / Centene $235 96%
Home State Health Plan Contracted [320187] $235 96%
Providrs Care Network Contracted [320484] $447 183%
Health Choice Contracted [320166] $665 273%
Cigna $912 - $935 374%
Medica Contracted [320239] $1,101 452%
United Medical Resources Contracted [320454] $2,565 1052%
Reflect Health Contracted [320492] $3,044 1249%
Yuzu Health Contracted [320521] $3,044 1249%
Healthlink Contracted [320179] $3,044 1249%
Aither Health Contracted [320449] $3,044 1249%
Edison Health Solutions Contracted [320502] $3,044 1249%
Mercy Benefit Admin Contracted [320251] $3,044 1249%
Ebms Contracted [320493] $3,044 1249%
Workers Comp [20426] $3,044 1249%
Imagine 360 Contracted [320494] $3,044 1249%
American Healthcare Alliance Contracted [320020] $3,044 1249%
Auxiant Contracted [320462] $3,044 1249%
First Health Contracted [320128] $3,234 1327%

Consumer Guidance & Cost Commentary

For the MRI, brain (no contrast) procedure (CPT 70551), Mercy Hospital Pittsburg, Inc. lists a gross charge of $3,805.00, which is significantly higher than the facility's own cash median of $2,473.00 and the state of Kansas average. While the facility offers a cash median of $2,473.00, commercial insurance negotiated rates vary widely, ranging from $110 for Medicaid/KanCare plans to $3,234 for certain contracted networks. Patients with high-deductible plans may find the cash price of $2,473.00 more affordable than their specific insurance allowed amount, which could exceed this figure depending on their plan. It is crucial to verify your specific deductible status and allowed amount before scheduling, as assuming an in-network rate is the lowest possible price can lead to unexpected costs.

To minimize financial risk, patients should proactively request a "self-pay" or "prompt-pay" discount before check-in, as hospitals often offer fee reductions for upfront payment that bypass costly insurance billing cycles. Additionally, if you receive a bill, always demand a full itemized CPT-coded statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed. If you encounter a balance bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services; in such cases, you should dispute the bill in writing with the insurer rather than paying immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals